Last week, I attended a webinar hosted by ADDitude Magazine entitled “ADHD and Gender: Girls, Women, and Stigma.” During the webinar, Stephen Hinshaw, Ph.D, professor of psychology at the University of California at Berkeley, gave a brief overview of how ADHD varies across gender. Currently, ADHD is significantly more common in boys than girls (3 boys to 1 girl). There are two main reasons for this discrepancy: (1) how ADHD is defined and (2) how the genders are perceived.

ADHD is defined primarily according to behavior, making it more applicable to the male gender role. While boys are socialized to be outspoken and animated, girls are socialized to be polite and controlled. This makes it difficult to identify symptoms of ADHD in girls. While it is possible that girls are actually less likely to experience ADHD, Hinsaw believes it is more likely that the difference is due to insufficient diagnostic criteria. This is evidenced by the nearly 1 to 1 ratio of ADHD in adult women to men. To resolve this discrepancy, he suggests including more verbal cues or “girl-like” symptoms in the diagnostic criteria. Although there is a risk of broadening the definition too much to the point that it is no longer “ADHD,” the current criteria seems to ignore the female expression of the condition.

The second reason for the imbalance in diagnosed ADHD is our perception of each gender. Boys are expected to be a bit wild. It’s what is commonly described as “boys just being boys.” As a result, hyper-activity in boys is less stigmatized; parents are more comfortable seeking help and acknowledging ADHD. However, girls exhibiting symptoms of ADHD are going against gender expectations. They are more likely to be dismissed as rude or unruly. It is seen as a personality defect rather than something to be diagnosed. As a result, more severe impairments are required before parents are willing to acknowledge their daughter’s lack of control over her behavior.

So why does all of this matter? Certainly, if these students are able to make it through school successfully without intervention, it could only help them. However, success is less likely for students who have been stamped with the stigma of failed gender expectations. The result is grim. According to Hinshaw’s research, girls diagnosed with combined type ADHD are likely to attempt suicide in 20% of the cases and induce self-harm in 50% of the cases. This means girls diagnosed with ADHD are 3 to 4 times more at risk of harming themselves than girls without ADHD.

Obviously, this is unacceptable. Girls should not have to hate themselves over any difference, let alone such a common difference. The takeaway here is just to be aware of how ignorant we are of each other’s situation. Although someone’s behavior may seem “weird” or even rude, it’s important to remember that s/he might not be able to control that behavior. If it’s difficult for you to accept his or her differences without understanding, try asking them why. S/he might not indulge you, but at least you reached out to spark a connection, offering a pleasant break from judgement.